Paula D. Roberts
Collegeville,PA
Summary
Dedicated Registered Nurse with thirty years of clinical and healthcare experience spanning maternal child health, case management, and care coordination. Certified Case Manager (CCM) with strong clinical judgement, assessment, research, documentation, and analytical skills. Experienced in evaluating complex medical and psychosocial needs, coordinating services, monitoring program outcomes, maintaining accurate records, and supporting compliance and contractual requirements. Skilled at identifying gaps in care, collaborating with multidisciplinary teams, communicating clinical concerns, and managing confidential patient information. Seeking to apply extensive clinical expertise and investigative aptitude to medical review and claims evaluation.
Overview
1
1
Certification
31
31
years of professional experience
Work History
Clinical Care Coordinator
Nemours Children’s Health
Wilmington, DE
09.2024 - Current
- Coordinate care for pediatric patients with chronic conditions and complex medical needs, using clinical judgment to support appropriate services and improved health outcomes.
- Assess patient needs and identify gaps in care, facilitating timely access to appropriate medical, behavioral, and psychosocial services.
- Collaborate with healthcare providers and multidisciplinary teams to promote continuity of care and address barriers treatment.
- Educate patients and families regarding preventative care, treatment recommendations, and strategies to support long-term health and well-being.
- Support coordinated, patient centered care for at-risk pediatric populations through communication, referral management, and on-going follow up.
Clinical Program Manager
United Healthcare Community Plan
Horsham, PA
08.2021 - 09.2024
- Managed a state-mandated maternal home visiting program focused on strengthening families, improving parenting skills, and supporting maternal and child health outcomes.
- Monitored program activities, referral tracking, and reporting to support operational effectiveness.
- Collaborated with internal teams, external stakeholders, and contracted service providers to meet program objectives.
- Monitored compliance with contractual requirements and program goals, supporting quality standards, and member satisfaction.
- Organized program information and maintained tracking processes to support timely reporting.
High Risk OB Case Manager
United Healthcare Community Plan
Philadelphia, PA
07.2019 - 08.2021
- Managed cases involving expectant mothers with high-risk medical conditions and complex psychosocial needs.
- Conducted assessments and developed individualized care plans based on clinical findings, identified risks, and patient needs.
- Evaluated ongoing care needs and coordinated services and community referrals to support appropriate care.
- Collaborated with healthcare providers and community partners to address barriers to treatment and facilitate continuity of care.
- Monitored maternity programs and trends to identify opportunities for quality improvement and recommend changes to care delivery.
Mother/Baby RN
Penn Medicine, Chester County Hospital
West Chester, PA
03.2018 - 08.2019
- Delivered individualized postpartum and newborn nursing care to three to four mother baby couplets.
- Assessed maternal and newborn status, recognized clinical concerns, and collaborated with healthcare providers to support safe patient care.
- Provided culturally sensitive, family-centered education and discharge planning.
- Reinforced patient education regarding postpartum recovery, newborn care, and preventative health practices.
Mother/Baby RN
Penn Medicine, Pennsylvania Hospital
Philadelphia, PA
04.2004 - 03.2018
- Provided comprehensive nursing care to postpartum mothers and newborns in a 50-bed unit, managing assignments of three to five mother-baby couplets.
- Performed maternal and newborn assessments, evaluated clinical needs, and collaborated with physicians and interdisciplinary teams to support safe, quality care.
- Participated in the hospital’s Baby Friendly initiative to promote evidence based breastfeeding support and family centered care.
- Served as a preceptor for new employees, supporting staff orientation, clinical education, and adherence to nursing practices.
- Assumed charge nurse responsibilities, coordinating unit assignments and supporting daily clinical operations.
OB/GYN Nurse
Wyoming Valley Health Care
Kingston, PA
01.2002 - 01.2004
- Provided nursing care to antepartum, postpartum, newborn and gynecologic patients. 1997-2001
- Served as charge nurse for twenty-four bed unit organizing daily assignments and coordinating unit activities.
- Assisted with staff orientation and supported consistent nursing practices and quality patient care
Medical-Surgical Nurse
Wyoming Valley Health Care
Wilkes-Barre, PA
01.1996 - 01.1997
- Provided nursing care to patients with complex medical conditions, including congestive heart failure, respiratory failure, and acute and chronic renal failure.
- Assessed patient status and collaborated with healthcare providers to support safe care and appropriate clinical follow-up.
Research Coordinator
The University of Pennsylvania
Philadelphia, PA
- Coordinated research studies within the Division of Maternal-Fetal Medicine
- Screened potential participants and enrolled eligible patients in research studies.
- Maintained study related records and performed data entry to support accurate documentation.
Education
BS Nursing -
Misericordia University
Dallas, Pa05.1996
BA Political Science -
Rosemont College
Rosemont, Pa05.1992
Skills
- Care coordination
- Patient assessment
- Care planning
- Clinical documentation
- Referral management
- Program management
Certification
Certified Case Manager (CCM), 05/2023
Timeline
Clinical Care Coordinator
Nemours Children’s Health
09.2024 - Current
Clinical Program Manager
United Healthcare Community Plan
08.2021 - 09.2024
High Risk OB Case Manager
United Healthcare Community Plan
07.2019 - 08.2021
Mother/Baby RN
Penn Medicine, Chester County Hospital
03.2018 - 08.2019
Mother/Baby RN
Penn Medicine, Pennsylvania Hospital
04.2004 - 03.2018
OB/GYN Nurse
Wyoming Valley Health Care
01.2002 - 01.2004
Medical-Surgical Nurse
Wyoming Valley Health Care
01.1996 - 01.1997
Research Coordinator
The University of Pennsylvania
BS Nursing -
Misericordia University
BA Political Science -
Rosemont College